Is the Government Going to Euthanize your Grandmother? An Interview With Sen. Johnny Isakson.

Sarah Palin's belief that the House health-care reform bill would create "death panels" might be particularly extreme, but she's hardly the only person to wildly misunderstand the section of the bill ordering Medicare to cover voluntary end-of-life counseling sessions between doctors and their patients.

One of the foremost advocates of expanding Medicare end-of-life planning coverage is Johnny Isakson, a Republican Senator from Georgia. He co-sponsored 2007's Medicare End-of-Life Planning Act and proposed an amendment similar to the House bill's Section 1233 during the Senate HELP Committee's mark-up of its health care bill. I reached Sen. Isakson at his office this afternoon. He was befuddled that this had become a question of euthanasia, termed Palin's interpretation "nuts," and emphasized that all 50 states currently have some legislation allowing end-of-life directives. A transcript of our conversation follows.

Is this bill going to euthanize my grandmother? What are we talking about here?

In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that's because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia "durable power of attorney," you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you're unable to make those decisions.

This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it's to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It's just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.

How did this become a question of euthanasia?

I have no idea. I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

You're saying that this is not a question of government. It's for individuals.

It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.

The policy here as I understand it is that Medicare would cover a counseling session with your doctor on end-of-life options.

Correct. And it's a voluntary deal.

It seems to me we're having trouble conducting an adult conversation about death. We pay a lot of money not to face these questions. We prefer to experience the health-care system as something that just saves you, and if it doesn't, something has gone wrong.

Over the last three-and-a-half decades, this legislation has been passed state-by-state, in part because of the tort issue and in part because of many other things. It's important for an individual to make those determinations while they're of sound mind and body rather than no one making those decisions at all. But this discussion has been going on for three decades.

And the only change we'd see is that individuals would have a counseling session with their doctor?

Uh-huh. When they become eligible for Medicare.

Are there other costs? Parts of it I'm missing?

No. The problem you got is that there's so much swirling around about health care and people are taking bits and pieces out of this. This was thoroughly debated in the Senate committee. It's voluntary. Every state in America has an end of life directive or durable power of attorney provision. For the peace of mind of your children and your spouse as well as the comfort of knowing the government won't make these decisions, it's a very popular thing. Just not everybody's aware of it.

What got you interested in this subject?

I've seen the pain and suffering in families with a loved one with a traumatic brain injury or a crippling degenerative disease become incapacitated and be kept alive under very difficult circumstances when if they'd have had the chance to make the decision themself they'd have given another directive and I've seen the damage financially that's been done to families and if there's a way to prevent that by you giving advance directives it's both for the sanity of the family and what savings the family has it's the right decision, certainly more than turning it to the government or a trial lawyer.

Part of the problem is a combination of fear and carelessness in wording. The GOP has been pushing the euthanasia/voluntary suicide hot button for YEARS, and any time any proposal from the left comes with the words "voluntary end-of-life counseling" they'll naturally go ape because they assume it's the "end-of-life" that's voluntary, not the counseling.

Messaging is crucial, and the GOP is expert at turning messages that are intended for the moderately astute into total freak-outs for "Regular Americans." Living wills get torqued into voluntary euthanasia; family planning becomes mass abortions; coverage for marital counseling becomes decreed divorces; school health counseling becomes homosexual indoctrination. I swear that by the time this is over somebody's going to take Everett Koop's statement that gun violence is a public health issue and turn that into "Obamacare will confiscate your guns!"

It's both intellectually and morally bankrupt, and there's barely any defense against it other than to gently suggest that Congress will make sure that any plan to make healthcare more available and affordable will not involve mass murder, reeducation camps, or martial law. Because absurd as it sounds, a whole lot of people actively believe that it will.

What's really sad as that here's a guy trying to help resolve a legitimate issue and it gets turned into propaganda. Instead of talking about killing grandma, we should be talking about the serious issue of expenses at end f life care.

It's a pity, though, that Sen Isakson hasn't come out to defend his legislative record against the distortions coming from his own party's crazies. He's a freshman up for re-election next year, so he may not want to make enemies among potential donors, but one of his first experiences in the Senate was when the Schiavo circus took place, so he ought to know better.

cdesp's right: this is dog-whistle stuff that's been around for years, erupted briefly during the time Bill Frist diagnosed Terry Schiavo by video, and is now audible to the masses.

"I don't know how this got so mixed up."
With all due respect, Mr. Isaakson, where have you been? It's your party and its leaders: Rush Limbaugh, Glen Beck, Sarah Palin. It's not an accident, it's not a good-faith misunderstanding. It's demagoguery plain and simple. It's lying. You seem like a good man. Now is the time to stand up for your country, which means standing up against your fellow Republicans.

Picture Frank American, who qualifies for and has enrolled in public health coverage, sitting on the butcher paper covered hospital examination bed receiving the news that he has condition X. It isn't caused by smoking or drinking or any other conscious choice by Frank, it is simple misfortune, but the prognosis is not good.

Frank elects to receive end of life counseling. During such counseling Frank repeatedly insists that he is prepared to fight this X all the way while the physician presents what his health insurance will and will not cover. In Frank's case, for whatever reason, there are no approved treatments even though some exist that have little to no proof of effectiveness but very high price tags.

Frank returns to his family, dismayed that his government would do nothing to help him and effectively condemn him to death.
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Has the government killed Frank? I think it would be better to say that X will kill Frank, but it seems from this prospective that the government is letting Frank die.

Which part of the government is letting Frank die? Obviously whoever decides what procedures to use, where, when and why. Thus a government panel has let Frank die because they could do something and have chosen to do nothing.

What people seem to focusing on in this debate/charade is a scenario like the above in which a government panel, with government interests, leaves someone with no options but to die, possibly by turning off the machines keeping him alive or five machine respirator sustained years later of X. To those people who seek counseling after a terrifying prognosis, being told their health care plan will do nothing makes them feel as if someone has told them they are not worth it. End of life counseling only seems to offer options on how to die.

If the government already runs Medicare, aren't they already killing Franks all over America? I wouldn't know, I just made the above story up to try and find some way of seeing another point of view. I do know that Medicare is well liked by the group of people most likely to be in Frank's position.

How is this different from private insurance? It isn't. Each company decides what it will or will not pay for. Private insurance companies have just as much incentive to cut out high cost, low success treatments as any public program would. I think what might be escaping some people is that in a health care system, no matter which, someone will always end up holding someone else's life in their hands.

This is just about the only thing I can come up with to justify what is being said about the present public plan, a situation which I've actually seen happen under private insurance. How it has become a situation in which the government removes all private insurance, forcing people into the public plan, and then starts to euthanize people is beyond me.

Having been through this with my father, let me say that living wills and durable power of attorney, while they supposedly provide directives (either in writing, leaving authority to technocrat medical personnel in the case of living wills or to family/rriends in case of power of attorney, they work only as well as communication between technocrats and family works.

In my experience, medical personnel steadfastly refused to give answers to a very simple question I was asking about exactly how the intravenous feeding was working, what the implications of stopping it were. To this day, six years ago today, I do not understand why they couldn't give me clear and understandable answers. I'm sure in the eyes of the hospital, I was a stupid family member insisting on expensive end of life treatment for no good reason. But from my perspective, I couldn't understand why answers from the "ethics expert" of the hospital took so long to arrive (always via intermediaries) and when they arrived, why they weren't answers to the questions I was asking.

Perhaps my experience is weirdly different from everyone else. But until medical personnel learn how to communicate better, durable powers of attorney won't contain costs.

I suspect, instead, that what the government and the technocrats really want is legal instruments that help them pull rank as "we are medical professionals, what do you know about it, Stoopid" so things can be done "more efficiently." Yes, I've had them say that to me, with regard to my octogenarian mother: we know better, shut up and let us work.

Has it dawned on the author of this piece that Palin might have been talking about The Health Choice Administration Commissioner and staff created under the bill that will create and enforce all standards of health care for the entire country, including private health care insurers (as he oversees and makes them comply with his standards). The poorly worded and vaguely presented end of life section is a symptom of how the Commissioner can interpret any section of the bill to give him vast power over all of our health care.
__________________

The loudmouths in the Town Hall meetings may not understand what they're bleating about but the Republican media and political leaders who are feeding them their lines sure as hell understand exactly what the bill does or does not say. Their goal is to preserve the status quo gravy train for the industries that pay them and honesty or understanding are not part of the equation.

LOL. Maybe you libs need to re-read that whole conversation Obama had with the lady about her 105-year-old mother.

This "end of life counseling" is a meeting where a government representative is going to talk to you about why you should take the nice cheap pain pill instead of getting that expensive, dangerous pacemaker operation.

I was on vacation and Grandmother left for a little or lot more extended vacation. The Grandchildren are still secure and all's well that never ends. Thank God for people who have nothing to say and can't be talked into saying it.

Running a Vacation Longer
I was running from You
Running forever away
Lost all myself and days
All my hope giving for You
Love no other could have
Without beginning without end
Looking for words for You
They found me running to You
Crying out to You come along
Let's go I have a place
Magnificent and wondrous
I could never run there
Without You near
Running forever away
It could never be lost
I fell to stop yours
My heart ran faster
To see you go higher
Never to fall again
Just to show You my love
From heaven to earth
Love always finds a way
Even when we are running a way
Love just knows the place
We shall be what is lasting
In loving memory of Grandmother

Digitized for the Washington Post. I wonder what the ad algorithm will do with that. Weight and sea boss and see bass for dinner.

whoisjohngaltcom, you can talk to any doctor you choose. Did you read the links? I'm guessing no because you don't have any interest in what the truth is. You just want to rail against "the man" even if "the man" isn't involved in any decisions YOU make about how you want your last years to be spent.

If people don't think private insurance has "death panels" you're delusional. The republicans keep saying that care will be rationed and, surprise surprise, when you actually read the section of the bill they keep pointing to it's nothing more than discussions about what will be covered under what plan. Basic, enhanced or premium. Obviously, the more you pay for a premium the more coverage you're going to get. A basic plan is just that. Basic coverage. Which, yes, I suppose could be considered "rationing" but, again, private insurers already have differing plans and you get to decide how much coverage you want to pay for. The republicans keep saying they want to ration or cut medicare when the bill says the exact opposite. It says that it wants to EXPAND coverage. It wants to close the "doughnut" hole left by G.W.'s Medicare plan D and EXPAND prescription drug coverages. It wants to try to fix what everyone says is wrong with Medicare.

The right wing is scaring the elderly population and getting them to rail against a bill that is going to help them. They should be ashamed of themselves.

The democrats do not have some secret plan to kill old people and disabled people. They overwhelmingly support medicare and medicaid, which was designed to help those exact demographics. If they wanted to kill old people they would be against medicare. If they were out to rid society of people who are supposedly "non-productive members of society" they wouldn't be for such programs as medicare, medicaid or welfare for the poor, now would they.

One minute they're "bleeding heart liberals" who want to give handouts to everyone and now they want to save a buck and kill off grandma. It would be laughably absurd if it wasn't so sad that gullible, naive, and willfully ignorant people wouldn't blindly swallow and accept everything the right says, no matter how outrageous, simply because they don't trust the scary black man in the White House and that the right has no problem fanning their seeds of hate and lingering racism.

Veritatemdicere, yours is the first time I have seen someone try to explain Palin's comment coherently. I understand that people feel disempowered when dealing with hospitals but I just don't see how end-of-life counselling makes this any worse at all. A calm, voluntary discussion while you are still well about what your wishes are might make dealing with technocrats a little easier but, even if it doesn't, how on earth does it make dealing with the cost-benefit geeks worse?!

"It seems to me we're having trouble conducting an adult conversation about death."

Correction: It seems to me we're having trouble conducting an adult conversation about ANYTHING. Birth certificates, "death panels," yadda, yadda, yadda. I have absolutely no faith that this will turn out well.

Interesting interview. Isakson would do well to read what Palin actually posted about "death panels", and to listen with greater care to the concerns being articulated about government involvement in end of life decisions. What provokes fear is not the explicit provisions of the proposed reform bills, but where they might take us.

Danielle Allen makes a number of great points along these lines in an op-ed published today in the Post:

I want to hear about the private or employer-sponsored health insurance plan that will let me go to any doctor I want, pay for any medication or treatment the doctor prescribes, and let me buy my prescriptions at any pharmacy.

I applaud people on both sides of the aisle trying to do the right thing for the average person in this country. However, I do understand how this message got so mixed. The GOP is specializing in twisting and turning things on their head only to get people who are nervous already to be very afraid. Name one issue they don't use scare tactics to entrench monied power.

That lying backwoods piece of trash wench Sarah Palin needs to take her own advice she gave to the media and "stop making thinks up." Now I will sit back and wait for for Palin's piece of crap watchdog lawyers to send me a cease and desist order for calling her a lying piece of trash wench.

anyone either for themselves or a parent knows, when being admitted today into a hospital, outpatient surgery or assisted living must provide a "health directive." for most people this is a done deal, included in their living wills or family trusts.

it is so like the machiavellian gop to play on people's ignorance and fears against logic and rationality.

The liberal Democrates and Pres. Obama's support of HC Reform and FOCA will have unintentional elimination of a racial group of America. When abortions increase in numbers, its the black community that pays the price. The Guttmacher Institute reports black women have abortions 5 times more than whites or hispanics. Its Genocide of the black community. Dems will tell you Abortion is not apart of the Health Care bill, but it is. Just ask the Rep. From California who wrote it it the hard to read bill.

This recovering Republican knows the terrain on the right - and if anybody is going to call for euthanasia for those who can't pay - its THEM!!

Republicans hate the poor. I know - I'm surrounded by them, was raised by them, and moved away from them to the Southwest.

Gopers don't want a government health program because they are afraid of '3rd world hordes' and their birthrates.

When I hear a Republican cautioning that government programs might fund abortions, I am reminded that the Republicans I know and grew up with think abortion for the poor is a TERRIFIC way to save the planet!!

Thank you, Ezra Klein and Sen. Isakson for cutting through the lies and hysteria and trying to set people straight. And I agree with the poster who said that Sen. Isakson needs to have the spine to stand up to his own party and tell them to cease and desist with the scare tactics and demagoguery.

It certainly shows up the various Betsy McCaughey Op-eds (paid for by the insurance lobby)with outrageous euthanasia & end of life rationing claims for what they are - - ugly distortions calculated to sabotage Obama's health reform.

What is stunning, however, is how this supposed "patient advocate" didn't give a flying f--- about the anxiety and distress she knowingly caused to elderly Americans with all her lies. That's why AARP called her "cruel".

As for Sarah Palin's "Death Panel", I think that came directly from McCaughey's 26 July NY Post piece, Deadly Doctors: Advisers want to Ration Care. Made Palin look very bad.

The only experience I have is in KY where both my father and mother had living wills that were not at all respected.

In one case the doctor continued treatment even reviving during surgery. In the other, the doctor refused to give end of life pain treatment because of fears morphine might be addictive or shorten life a few hours.

Laws will not change anything around the issue of death unless tort and methods of evaluating doctors and hospitals are changed.

Hospitals and doctors do not want deaths in their surgeries or wards if they can possible avoid them. Their statistics & reputations are at stake.

ronjaboy mused: "They want to make SURE the doctors talk people into these end-of-life directives, so the medical establishment can pull the plug as soon as possible."

They? Wo are "they"? Rep. Isakson? And if "they" want this why has it not already been done with Medicare or social security? And just where did you get your information, or did you, like Sarah Palin, just make it up?

ronjaboy, you are one of the truly ignorant. The OPTION to talk to a doctor OF YOUR CHOICE (what? do you think all doctors really want to kill you?) is entirely VOLUNTARY and, as the article stated, is ALREADY in place in EVERY STATE. All the bill is going to do is make sure those consults OF YOUR CHOOSING are covered by insurance. If you want heroic measures taken, then put it in your living will. Let your family know and appoint a durable power of attorney. That's all this whole thing is about. Legislation that is ALREADY in place but is currently not covered by insurance. To make sure people let their wishes be known but to also give you a chance to educate yourself on just what is considered a "heroic measure" or your preferences in regards to hospice care or to educate yourself on new treatments and adjust your will accordingly every five years IF YOU SO CHOOSE.

Something else getting conflated and then stomped upon in this "debate" is that not all treatments should be paid for, either by the government or private insurers.

If Frank--to expound upon Vigo's example below--were diagnosed with a terminal cancer for which there are no known effective treatments, should Frank have the right to demand they "try everything," including alternative medicine of questionable value? If Frank read about some "treatment" in a blog--say, drinking the purified urine of a particular frog--and finds a "doctor" (or huckster, more likely) willing to perform it for the ultra-low price of $150,000, and the government says, "Sorry, that treatment isn't proven effective, and we're not going to pay for it--but we will pay for pain killers to help manage your suffering," is that really the government deciding to kill Frank, or even to "let him die?"

The answer is no.

And though this is an extreme example, the line must be drawn somewhere; is everyone entitled to have every treatment, no matter how remote the chances of success or the dubious track record of such treatment, paid for by taxpayers or their private insurers?

Again, the answer is no.

Yet the oppositionists are already casting this as being a "death panel," "killing Granny," etc.

It's ironic, really, and up there with the ads talking about "government bureaucrats" making your decisions (instead of, what, insurance company bureaucrats?), or the lady at one of the town hall meetings who, with no apparent irony intended, shouted, "Keep the government out of my Medicare!"

sambam wrote: "Will wonders never cease - an Republican willing to speak up against reigning party loonies Sarah Palin and Newt Gingrich to set the record straight! How long do you think it will be before he apologizes and starts walking back his comments?"

I was thinking the same thing. When will Limbaugh demand an apology and cause Isakson to scurry to the microphone to denounce Obamacare. That is why Isakson is not publically denouncing the liars and goons. Funny how the party of using fear in politics is itself gripped by fear of Limbaugh and fear of the truth. The party of "nothing to fear but fear itself" can see through what the republicans are doing and just shake their heads, wondering when their insanity will stop.

What b.s., Palin didn't say anything about euthanasia, she said government panels would decide who gets treatment based on their productivity to society. Her statement is backed up not only by the language of the bill, but also by the many statements of Obama's advisers. Let's face it, when taxpayers are paying for everyone's care, and costs start skyrocketing, which they will, do you really think your elderly grandmother is going to get that hip replacement that will let her spend her last few years at home, instead of a nursing home? I believe someone recently said, maybe it's better to just give her the pain pills instead of the operation.

Veritatemdicere, I had a somewhat similar experience, but with more info. When we had to decide whether or not to have a feeding tube inserted in my father, who had had a near-crippling stroke, they did not explain that once it was in they could not ethically remove it. That was only explained later when I wanted it removed. In addition, the dr who was on duty when the decision had to be made had been a Vietnamese boat person, and assured me people could live only a couple of days without hydration. Because my father wanted to see his about-to-be-born great grandson, I had them out the tube in. He removed it himself after he had heard that the boy had been born. But people who are dying in a hospital or nursing home don't go right away. Their systems have shut down so much that they can live for as long as a month.

I am very grateful that both my parents were very explicit during their lives about what they wanted and didn't want, and both had advance directives so we could do what they wanted.

"If Frank--to expound upon Vigo's example below--were diagnosed with a terminal cancer for which there are no known effective treatments, should Frank have the right to demand they "try everything," including alternative medicine of questionable value? If Frank read about some "treatment" in a blog--say, drinking the purified urine of a particular frog--and finds a "doctor" (or huckster, more likely) willing to perform it for the ultra-low price of $150,000, and the government says, "Sorry, that treatment isn't proven effective, and we're not going to pay for it--but we will pay for pain killers to help manage your suffering," is that really the government deciding to kill Frank, or even to "let him die?"
Posted by: exerda | August 11, 2009 12:10 PM |"

What if Frank found a treatment that gave him a 95% chance of living an extra 6 months for $150,000? Should the taxpayers pay for that? What if there was research into a cure going on that looked promising, and who knows, in 6 months, maybe there would be a cure? The point is, do you really want a government bureaucrat making that decision? Especially when in most single-payer, government-run systems, people aren't even allowed to pay for non-covered treatment, if they have the money and inclination to do so. It's never quite as simple as you want to make it.

I don't know where you nutters have been- but private health insurance doesn't give a damn about your grandmother. Insurance companies withhold treatment ALL THE TIME. Did everyone miss the congressional hearings awhile back where it was revealed that the gatekeepers at the insurance companies were getting kickbacks for denying treatment?
Insurance companies are beholden to their SHAREHOLDERS not to their PATIENTS.
Quit blindingly buying what you're being fed by Insurance Co's that don't want to lose their billions of dollars a year racket, and do some reading & thinking that compares & contrasts the facts, and the history of the behavior of insurance Co's over the last 5-10 years ON YOUR OWN.
(former Conservative Republican. Current Independent. Member of the Society of the (US Army) 3rd Division. Card carrying NRA member.)

mbs235 wrote: "What if there was research into a cure going on that looked promising, and who knows, in 6 months, maybe there would be a cure? The point is, do you really want a government bureaucrat making that decision?"

Right now a for profit insurance company bureaucrat would say no.

"in most single-payer, government-run systems, people aren't even allowed to pay for non-covered treatment, if they have the money and inclination to do so"

The "Death Panel" remarks are specifically responses to the "Deadly Doctors" column in the NY Post by Betsy McCaughy, former Lieutenant Governor of New York and founder of a healthcare foundation. She produces many quotes from two top Obama advisors, Drs. David Blumenthal and Ezekiel Emanuel, who specifically argue for witholding care from the disabled or demented or aging, and for slowing the pace of technical innovation. All in the name of "communitarianism" (Emanuel's word not mine or Betsy's).

Palin's absolutely correct. Ezra and this feckless GOP jerk are simply ignoring the published opinions and testimony of the key advisors aiding the President.

mbs235 blathered: "What if Frank found a treatment that gave him a 95% chance of living an extra 6 months for $150,000? Should the taxpayers pay for that?"

Many cancer treatments only prolong life for a few months statistically. They are covered both by medicare and private insurance. And cancer treatment is not cheap, especially those which require hospitalization to administer.

mbs235 blathered: "What if there was research into a cure going on that looked promising, and who knows, in 6 months, maybe there would be a cure? The point is, do you really want a government bureaucrat making that decision? Especially when in most single-payer, government-run systems, people aren't even allowed to pay for non-covered treatment, if they have the money and inclination to do so. It's never quite as simple as you want to make it."

Currently most insurers would call that treatment experimental and not cover it. Why does a private insurance company's decision, which is based on profits and CEO salaries in the hundreds of millions, more acceptable to you than a government bureaucrat who has no monitary incentive?

mbs235 blathered: "The answer is no."

Think about Medicare and how it has saved the lives of people with end-stage renal disease, a condition that was so expensive in the 1970s insurers would not cover it since it also kept the person alive indefinitely (expensive and long term). It was Medicare that legislation provided to these people with end-stage renal disease that stopped the thousands each year from dying due to an expensive but completely treatable condition that private insurance refused to cover.

Now, if you had end-stage renal disease would you trust your private insurer or Medicare? Would you want the private sector's profit motive working for you or a government system designed to provide care for all if you end up with an expensive but treatable condition? Both the government and private insurance have shown in the case of end-stage renal disease how they would act.

Just wondering aloud where the outcry about the euthanasia nonsense was when republicans and democrats alike were urging everyone to go out and make a living will and appoint a durable power of attorney after the Terry Shiavo fiasco. Did they all want everyone to choose death? No. They wanted everyone to make their own choice and make sure it was known and in writing before the unthinkable happens. As the senator said in the article, this is putting the choice in your hands and taking it away from doctors, government or lawyers. Is a living will an absolute end to it? No, because family can still argue and try to enforce their will on the situation and try to fight who you give power of attorney to and try to argue that you'd changed your mind and hadn't gotten around to changing your living will and, yes, doctors can be less than helpful or even stand in the way of what you expressly want but having a living will is a starting point. Having a living will is better than not having one and having no voice at all.

Its the Terry Sciavo situation all over again. Republicans attempted to prevent any counseling on end of life situation then for immediate family, and are attempting to do so now. They went as far as to attempt to codify in federal legislation.

"The husband of a woman who died of cancer but was denied free NHS treatment because the couple chose to pay privately from their savings for a drug to prolong her life yesterday urged the government to change its guidelines." http://www.guardian.co.uk/society/2008/jun/02/nhs.health
Private insurance was prohibited in Canada until a Supreme Court ruling in 2005, and whether providing care privately is legal is an open question. http://www.city-journal.org/html/17_3_canadian_healthcare.html

To those who are defending Palin and saying that she wasn't referring to this part of the Bill,etc., you need to stay current.

Palin's own representatives spoke with ABC yesterday and told them specifically that this is the part of the Bill that she was referring to by "death panels".

Now, the co-sponsor of the Bill (who is a Republican not a Democrat)says her interpretation is "nuts", and yet you somehow still believe Palin...or Rush...or Beck....and not the co-sponsor of the Bill. I'll repeat...he is a Republican. Amazing.

dummypants actually wrote: "does anybody think health care has not gone off the rails for good if the liberals are busy trying to convince people that this wont lead to euthenasia?"

So you are saying that unless the democrats can get a word in edgewise to defend themselves against lies, the legislation is dead? No wonder people are lying and twisting hoping to kill this bill so private insurers can continue to profit off the sick. The charge is extraordinary therefore the onus is on those maning the claim to show how the legislation will lead to euthanasia. So far the only thing that I've heard is that it is "inevitable". No quotes from the bill(s), no evidence at all. But they want the sane among us to prove them wrong. Sorry, I don't have time to prove obvious lies to be wrong.

dummypants actually wrote: :when will the MSM realize that reform is dead."

In your dreams. Reform is coming and in 5 years teabaggers will be defending it as many of these teabaggers are defending medicare in their own twisted logic sort of way.

hussein's "MANDATORY Healthcare End-Of-Life Counseling" for seniors: "Take either the red pill or the blue pill. With the red pill you die immediately. With the blue pill you die tomorrow. Choose your pill, NOW!"

Achtung! The new political order is here!

You, citizens of our socialist society, have an obligation to do what is best for the Fatherland. If you are not part of the solution, you are a problem. Economic growth and strength of the Fatherland DEMANDS THAT PROBLEMS BE ELIMINATED.

If you are a senior or are weak, sick, infirm, a deviant, handicapped (mentally or physically) or retired, you MUST take one of the pills offered by OUR BELOVED MESSIAH. If you do not comply, you will be shipped to one of the "camps".

Thank you Ezra, for bringing this up. I knew that Sen. Johnny Isaacson had a hand in this. But nobody bothered to bring it out, except Keith Olbermann & Rachel Maddow. If enough noise was made about the originater of "death panel" idea, idiots like Sarah Palin would have been shut up for good. I hope WP will have the good sense to print it in the hard copy tomorrow.

Thank you Ezra, for bringing this up. I knew that Sen. Johnny Isaacson had a hand in this. But nobody bothered to bring it out, except Keith Olbermann & Rachel Maddow. If enough noise was made about the originater of "death panel" idea, idiots like Sarah Palin would have been shut up for good. I hope WP will have the good sense to print it in the hard copy tomorrow.

Well, another vital public issue dominated by the low end of the Bell curve.
Further proof that our public school system does an excellent job of turning out high school graduates that are as incomprehensible as a cow watching a car go by.

Being from Alaska I need to tell you that our former governor is not now nor will ever be anything more than a spokesperson for the far, far, far right. This is the real reason she is no longer in office. Only a tiny percentage of Alaska's tiny population supported the majority of her positions on much of anything. Just stop giving her print space. Your teenage kid has a more informed opinion than she does.

PS Senator McCain opened the Pandora's Box that unleashed Sarah Palin on to the American political scene. He should do the responsible thing and help put her back in the box. I find it highly unlikely he agrees with her extreme positions either but he is utimately responsible for her momentary "fame". How about saying what you really think Senator? Even if it is painful to admit your error it would be the honorable thing to do...

I doubt if this post will see the light of day.The last one didn't.Still here goes.
People don't depend on this blogger or anyone else. Look up the info for yourself. Don't get stuck in the left or right,Democrat or Republican paradigm. Look the bill up yourself and read it. Do a news search. CBS,U.S. News and World Report and many others have written about this issue. 1.6 trillion will be cut from Medicare and Medicaid. That's the poor and the old.There will be rationed care.Taxes will be raised and by quite a bit. The free health care will cost a lot. You will be fined if you don't have health care insurance.
Look all this up. Do your own homework.

after doing a line, steveb777 sneezed: "People need to wake up and see this lying fraud for who he is, an America hating, Saudi King bowing, dictator loving, former cocaine addict, racist Kenyan usurper dirt-bag Chicago thug!"

The only two assertions in that sentence that don't apply to GW Bush are Chicago, and Kenyan (and I'm not sure about kenyan...wakka wakka). GW Bush did more than bow to the Saudi king, he went on a nice hand-holding snuggle walk with him. Was that before or after GW Bush smuggled Bin Ladens family out of the country?

More proof that using Fox news as your ONLY source of info leads to neural atrophy, and visual blindspots. (It's a great source for comparative usage, it brightly illuminates what big Banking, Oil, Business are telling our representatives to spoon feed to us- well, those of us willing to stand on our knees, with our mouth open gobbling it up)

At a helathcare dictatorship dispatched statement of You will enjoy zis.

(They seem like little else, since representation stopped listening to the majority of the people who said No on bailouts, stimulous, and porkulous).

I went towards a chant that was saying "redress the Fed" by attendees who were stuck outside for not being of the correct party affiliation to go in.They were not willing to return to their abusers again to try to say anything.

They have a Demand of redress of the Untied States Federal Government seated 2009 for No Confidence and recall ( all names) in he Hill, the cabinet, the czars, and Obama, being signed by American citizens of all ages to be recorded in the Country recordations office as a document.

They then will pool it with other Countys to be entered by the people of the State into a Library of Congress document.

When 49 others do, the documentation phase of the historical change will be complete.

Everyone wants change, but it is to have their Constitution and Country back ...not "Mc worse than Bush" challeges to rights with people watching.

It looks like Obama's waterloo has arrived.

He is done, and paperwork by the masses is being filed that say so.

No Confidence could be over a plethra of Obama Unethical Court secrets ,cronyism to squeeze a policeman, to Ceo firings and a give away of our Icon,to missing money.

No confidence covers a million bases for everyone, and the 2 words have no arguments.

If the redress petition is successful. The people seem set on and emergency election placement of a POTUS Lieberman, (if he quits participating in theis wermact as so many have been doing recently, to keep their names off of the role call of redress recall)

No one wise wants their name in the Library of Congress in history as a "No Confidence vote" by the people.

Mr. Klein does a great disservice to this entire topic by not giving everyone full information. I base this on people's posted comments that Senator Isaakson is spineless and wondering why he hasn't spoken up before now.

Sen Isaakson's amendment DID NOT make it into the HELP committee version of the Senate bill. Section 1233 referred to in the article is from a version of the HOuse bill, HR 3200. The amendment in the house bill was sponsored by a democrat, Rep. Earl Blumenaur of Oregon. Rep. Blumanaur, as a state senator several years ago, was also instrumental in bringing assisted-suicide laws to Oregon. I believe this is where the hysteria about Section 1233 is derived from.

And since Senator Isaakson is a senator, not a representative, he'd have no idea what's in the House bill...and why would he? Even House members haven't read the bill!!!

Ezra:
Let every man, women, and child read this interview. With this interview in your hands you should seek comments from all fear mongers to clarify on camera the basis of their comments. I visited the office of Congressman Lee. His executive assistant repeated the same lie. When I challenged her, she just smiled and had nothing to say. It is the responsibility of the media to track down every politician who is spreading this falsehood and demand retraction. We should not let them go until they retract their comments and apologize on camera. Media should sit outside their home, office, church to make sure that the world sees what they really are. But, will American media really do it? No because they are part of the problem

Any chance we can have healthcare reform conversation like adults? Whats wrong with end of life counseling? As does Palin, does she ever stop and wonder how many mentally handicapped people are currently without health insurance? How are families with limited incomes and sometimes who cant work to care for a sick relative managing?

And how will our workers compete in the global economy when all other developed countries offer free medical cover for their workers and businesses dont have to do that?

If you've always paid your premiums on time, you're as likely to be dropped by a private insurance company when you need life-saving care as you are to get treated; even if you aren't dropped, they have the ability to overrule your doctor's advice for life-saving treatment and only offer to cover something cheaper.

Private insurance companies are spending $1.4M a day to kill the public option, inventing phony citizen groups, and trying to scare the elderly about euthanasia and pro-lifers with abortion; they know the only way to kill reform is to get people of good conscience fighting each other, while they laugh all the way to the bank.

The average American family pays $16K/yr on health care while the avg. Canadian family pays less than $2K/yr, and businesses can no longer afford to provide insurance under the current system. Every independent estimate says the public option will SAVE the government money, from anywhere between $150B (CBO) to $265B (Commonwealth).

So - if you'd rather spend more taxpayer money, bankrupt businesses, AND pay $16K a year for your family's private insurance coverage in exchange for a policy that can be dumped the second you actually need it, then the current system is great for you. If you'd rather spend less, have less of a chance of dying, and want to remove the corporate bureaucrat from between you and your doctor, then a public option is the way to go.

When you need life-saving care, private insurance companies only profit by denying you and letting you die. If you have paid your premiums on time all your life, you're as likely to be dropped by your private insurance company when you need life-saving care as you are to get treated. A public option gives you a lifeline.

Private insurance companies are spending over a million dollars a day to kill the public option by inventing phony citizen groups, and trying to scare the elderly about euthanasia and pro-lifers with abortion; they know the only way to kill reform is to get people of good conscience fighting each other over misinformation, while they laugh all the way to the bank.

We pay more than any other country to be 24th in life expectancy: while the average Canadian family spends less than $2000 a year on health care with no waiting periods for life-saving care, the average American family spends $16,800 a year, waiting for private insurance companies to approve life-saving treatments.

Fourteen thousand Americans lose their health insurance every day; over forty-six million are currently uninsured.

Eighteen thousand Americans DIE each year due to lack of health care: THAT'S 50 A DAY.

Nearly two-thirds of American personal bankruptcies are related to health care costs.

Businesses - particularly small businesses - cannot afford to provide health insurance for their employees under the current employer based private insurance system, and will be forced to either drop their coverage or go out of business unless a public option is passed.

One-sixth of all our government spending is on health care, twice as much as any other country spends out of its budget. Our nation pays $2.5 trillion for care costing $912 billion.

Every independent estimate says the public option will save us money, from saving 150 billion dollars (CBO) to saving 265 billion dollars (Commonwealth). The Congressional Budget Office estimates the current bill in the House would actually leave a 6 billion dollar surplus

So - if you'd rather spend more taxpayer money, bankrupt businesses, AND pay $16,800 a year for your family's private insurance coverage in exchange for a policy that can be dumped the second you actually need it, then the current system is great for you.
If you'd rather spend less, wait less, have less of a chance of dying, and want to remove the corporate bureaucrat from between you and your doctor, then a public option is the way to go. Right now, even if you're lucky enough not to be dropped by your provider when you need urgent medical care, your private insurance company can overrule your doctor's advice for life-saving treatment and only offer to cover something cheaper; a public option would remove that middleman and leave these decisions where they belong, between the patient and doctor.

How is it NOT OBVIOUS that the ONLY people who are really benefiting from the current system are the Insurance Co's?

Again, they are responsible to their shareholders, to make a profit.. NOT to their medical patients. It is a clear conflict of interest. There is no flip side to this. No "pro" that counterweights this "con".

Perhaps Palin is on to something. Instead of a 'Death Panel,' we need a Stupid Panel so all the idiots in the GOP be forced to live in Alaska. How about it, my fellow Americans. The lower 48 would be 30% smarter.

Mr. Klein mis-interprets the opposition to the so-called Health Care "Reform" movement in Congress. Or perhaps maybe his editor told him exactly what propaganda to write in order to support the efforts of Washington to pass legislation that nobody out in the Real World is interested in.

Poo-poo'ing "mis-informed" americans for being scared of "death panels" is a very arrogant way of dismissing the real reason for oppositon. What's next Mr. Klein?? are you going to suggest that we all just "eat cake"?

A lot of cases of willful blindness here, including my homeboy Johnny I.

Palin is on target again. If the government runs health care, there WILL be rationing, and the very young, the infirm and the old may be denied treatment due to their lack of societal productivity. In other words, government workers (union members) will be deciding who is denied treatment--and in effect a death sentence. There may not be an actual panel, but the end result witll be the same: The government will determine who gets to live and die. Of course, you won't find this spelled out in the bill but unless language is written into the bill precluding any form of death panel, the government will have the option of playing the "death panel" role. Palin is right. When the government has control of a nation's health care, it has too much power and will end up playing God--and you can't trust dishonest politicians to tell the truth about it.

RandyChandler actually said: "Palin is on target again. If the government runs health care, there WILL be rationing, and the very young, the infirm and the old may be denied treatment due to their lack of societal productivity."

Hmmm, well, there is government run Medicare, Medicaid, the VA and many miliatry hospitals. Where is the rationing? Where is the denied treatment?

RandyChandler actually said: "In other words, government workers (union members) will be deciding who is denied treatment--and in effect a death sentence."

Oh NO! Government workers making decisions! How awful! Why I just love the bureaucrat at Blue Cross Blue Shield who is telling me that I should have called first for "permission" beofre I had that colonoscopy, so now they won't cover it. And God help me if the biopsy comes back bad. Yes, I love that bureaucrat and their supervisors who I am in a struggle with now. So much better than a government bureaucrat whose job in current government programs is not to save money so the CEO can have a $100+M salary but to make sure Medicare recipients receive care.

RandyChandler actually said: "There may not be an actual panel, but the end result witll be the same: The government will determine who gets to live and die."

So you admit Palin lied? And if government deciding who will live and die is so inevitable why is it not happening now under existing government health care? And why is it actually happening under private insurance?

RandyChandler actually said: "Of course, you won't find this spelled out in the bill but unless language is written into the bill precluding any form of death panel, the government will have the option of playing the "death panel" role."

I see, so if its not in the bill its allowed. Where did you go to school?

RandyChandler actually said: "Palin is right. When the government has control of a nation's health care, it has too much power and will end up playing God--and you can't trust dishonest politicians to tell the truth about it."

You're right about dishonest politicians and not trusting them. Your problem is you can't see a dishonest politician when they are lying to you from Alaska.

Fate1 (don't trust anyone who won't use his real name) apparently doesn't know how the legislative process works. And of course he resorts to the usual liberal tactic of attacking his opponent instead of presenting facts or rational thought.

Well, Fate1, if you don't see a problem with the government takeover of health care or have any misgivings about the longterm consequences of such a system, then all I can say is: Good luck with that long and happy life in ObamAmerica.

By the way, insurance companies can be brought to heel by intelligent changes in the nation's laws but the same can't be said for a mammoth government bureaucracy. Never mind that there is no way to pay for Obamacare. The plan under discussion isn't even Obama's plan, because he has no plan. What you have is a thousand-page doorstop written by radical leftist lawyers and zealots.

There is no healthcare crisis. You've been had. Pretty soon you may be standing in line for your maintenance dose of government Kool-Aid. Get used to long lines--I see a lot of them in your future.

"But on reflection, I realized that Palin's shrewdly timed metaphor spoke directly to the electorate's unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished."

Randy,
Your fear of the government makes me wonder what other socialist government services you fear. Do you not fly because of the FAA control of the skys? Do you stay off the federally controlled highways? Do you not trust the FBI? Are you afraid of the military invading your home? Do you not trust the weather report because the information came from NOAA? Will you not take the flu vaccine this fall because it was designed by the CDC? Will you not take a cancer treatment because the treatment was likely invented under an NIH grant? Do you run into your house and shut your windows every time the space station flys overhead?

Your vision of the health care plans is not accurate. None of the plans have government "running" anything new. Your doctor will not be a government employee, hospitals will not be government owned or run, and there will be no one in government deciding who lives and dies. This is all made up, unless you can point out any specifics in any of the plans under consideration. Health insurance companies will still be running things but under new regulations, which sounds like what you suggest. The same is happening on Wall Street with the fed and sec working to come up with new regulations but no one is calling that socialist. And if a government run health system is so draconian why does the military love the VA, the elderly love Medicare, the poor love Medicaid?

You are running on fear accepting anything that feeds your fear. And if you think there is no healthcare crisis you must not know anyone who has lost their home, spent their entire savings or gone bankrupt because they cannot pay for necessary healthcare. You may think your current insurance will protect you from anything, but read it closely, it has many limits. You can lose it all with one fall, one bad diagnosis, one blood clot. But your insurance company's CEO will not lose a dime of a multimillion dollar salary. If you think an unmotivated government is scary why are you happy with a company who wants to maximize its profits and reduce costs paying for your healthcare? If anyone has an incentive for death panels its your insurance company and if you read the history of end-stage renal disease back in the 1960s you will see who actually had death panels and who made sure that today no one is dying from that disease. If you care to learn something of course.

Fate, your blind faith in the government is almost touching but it's also frightening. Your confidence in government-controlled health care is unfounded. It doesn't take that much foresight to see where this is all leading and that government control will turn today's "crisis" into a disaster.

Your basic mistake is believing that only the government can run the nation. History shows us that governments run nations into the ground. The best government is one that gets out of the way, but that won't happen when so many people think they are owed a turn at the government teat. And the cow is dry now. You can't destroy the economy and expect it to sustain a massive health-care system revamped by special-interest groups and radicals. It's a prescription for chaos.

[By the way, if your faith in government seems highly selective. Do you not believe the U.S. Government Accountability Office figures on the Dem's health care plan? And still millions would be left with no coverage. The whole scheme is nuts.]

Keep that Hope & Change thing going if you must. But don't be surprised when reality blindsides you. You can't run a nation on campaign speeches and empty promises or by printing money because you're already bankrupt. But if you want to destroy free-market economy, this should be a pretty good plan. But you'll need steely nerves and a strong stomach because you're going to see a lot of lives destroyed as what's best of America goes down the tubes.

I'm not for complete government control but not because I fear it. I haven't heard about any disasters in Medicare.

In 2000 I was laid off when the company I worked for went backrupt. They did this on the 30th of the month. By law medical coverage must continue until the 1st of the next month. The lousy executives planned it so that our post-employment coverage lasted one day. I am the only worker in my family. I have a wife and child. The next day none of us had health insurance. I quickly applied to Cobra and was floored at the cost, much higher than what me and my company were paying for my insurance before, yet nothing about me or my family had changed. I still had life insurance I bought privately, I had car insurance, home insurance. None of these were affected by the lay off. But for some very strange reason health insurance was. That needs to end.

And history does not show governments run nations into the ground. Just where did you learn your history? But I agree the best governments stand aside and let the markets work where they can, but government cannot be completely hands off, and government must meet needs where the private sector cannot. There have been many cases where the private sector failed in healthcare, the elderly being one, end-stage renal disease treatment being another. It is government's job to step in where the private sector fails or cannot function. We avoided a depression because government stepped in. The government has a job and I see it now stepping in where the private sector has failed to meet the health care needs of many Americans. If the markets worked, why are there so many uninsured? Why can I only consider paying for the 3 healthplans my company offers, only one of which comes close to what I want?

Are the plans perfect? I'm sure they are not. The old adage that a mule is a horse made by committee is very true, in government and elsewhere. But even a mule is better than where health care in America is now. If nothing changes healthcare costs will continue to skyrocket. Rationing will occur and it will be your insurer who will do it by taking off procedures they don't want to cover, raising deductibles, etc. They will not lose their profits to save one life, so please understand they are truly the ones to worry about and have proven as much.

And who is talking about destroying a free market economy with any of these plans? Is FedEx or UPS destroyed because the postal system exists? This is the problem with the arguments coming from those demonizing the plans. Many arguments simply make no sense, consider the government to be toxic to anything it touches and will take over all of healthcare, none of which is true. If we could just deal in reality lies like death panels would not come up. DeMint already explained why this is happening - Obama must lose so he will be defeated and demoralized, his Waterloo. The last thing on their minds is your health care.

How about 30% overhead for private insurance (mainly profits and administrative costs) vs. 3% for Medicare (which, some people need reminding, is a government program)? What do we get for that 27-point difference? We get lots of paperwork, and we get to underwrite the insurance companies' profits.

Please note that the insurance companies are NOT providers of health care. They are middlemen with an incentive to maximize premiums and pay as little as possible in claims, not to make sure that good care gets delivered.

Or how about the fact that the U.S. spends far more per capita on health care than any other nation, and yet almost all the developed countries that have nationalized health care have better outcomes -- greater life expectancy, lower infant mortality, etc.

The shame of it is, even after a reform package passes, we'll still have far LESS "government control" (your bogeyman) than most developed nations.

The fun part, after reform passes, will be when the sky DOESN'T fall and you and the other fearmongers will look ridiculous.

Next I suppose you guys will tell me that Obama is saving the economy. I'm out of time here but two questions need answering.

1. Why should the federal government control health care?

2. Why should we trust radical leftists (Obama and most Dems) to "revamp" the nation's health-care system? Many of them are on record as saying they want a government-run single-payer system, and others are lying about their ultimate goals. Congress has raided Social Security and left IOUs and they're on their way to breaking Medicare (which many seniors have paid into for many years). How can we trust these lawmakers?

Because private industry control has benefited all parties except the patient. Because existing government run health care systems (Medicare, VA) have higher patient satisfaction, better outcomes, and lower costs. Instead of hypothesizing about the future, simply compare existing private vs. public.

Randy sez: "Why should we trust radical leftists (Obama and most Dems) to "revamp" the nation's health-care system? Many of them are on record as saying they want a government-run single-payer system, and others are lying about their ultimate goals. Congress has raided Social Security and left IOUs and they're on their way to breaking Medicare (which many seniors have paid into for many years). How can we trust these lawmakers?"

Because radical rightists have handed us the current recession. In 8 years they've turned the US budget surplus into a massive deficit. Because the radical right has run up $10B of national debt.

My family has employer based insurance and I can tell you that the mindless decisions about our healthcare made by BlueCross/Blueshield scare me far more than the prospect of a public healthcare payer option. We spend 100+ hours a year arguing with our insurer about the most basic of healthcare needs. They approve, then decide arbitrarily not to pay. We appeal...months later they sometimes pay. There's nothing exotic, experimental, or expensive here, just BC/BS grinding down another family. Bring on the public option!

The moral hypocrisy of the radical right is difficult to comprehend. How, in one breath, can one espouse the "right to life", yet in the next breath not show compassion for the 50 million uninsured, a compassion that no other developed country in the world denies.

Randy: no need to fear monger about the future. Just go without health insurance right now, like 50 million of your fellow countrymen!

As I said before, the health care industry and all its various parties can be adequately regulated, but a sprawling federal bureaucracy cannot because it is too corrupt and its elites are too well-insulated.

The industry's problems could be solved without a trillion-dollar plan that won't work but the Democrats won't allow more rational options to be discussed. They will settle for nothing less than government-run health care.

It doesn't take a genius to see this for what it is: An insidious power grab. Same with Cap and Tax. Connect the dots and stop believing the official lies.

Bottom-line time. We are approaching the moment of truth. Will the people stop the out-of-control government from gutting America? I'm betting we will. We have a history of fighting to the death to remain free--and that means free from government oppression as well. The grownups (many of them senior citizens) are about to take control before things turn really ugly.

This is no longer about Left and Right. It's about survival. We are way beyond the usual political games here. This is for real. We the people are going to remind the political elites that they work for us, not vice versa. We won't be hoodwinked, and they won't lie to us and get away with it.

That change you heard so much about? It's coming for real this time. Buckle up.

Sarah Palin is the master of catchy phases to make a simplistic point. It feeds red meat to folks who really do not want "discussion time." What makes more sense is for sensible politicians and others to have sane discussions about how we can make progress in improving our nation's health care system. In the end, a political decision can be made by the majority party in charge. Hopefully, we will soon move forward, at least with ending insurance companies from denying coverage to people with pre-existing conditions. And, hopefully, we will move forward with a public option for that 20-25% of Americans who are shopping for health insurance and want the same choices available to federal employees. Want to see what they have to choose from? Go to http://www.opm.gov/insure/health/planinfo/index.asp